HPV5b variant in a neoplastic lesion of an Italian patient affected by epidermodysplasia verruciformis.

Epidermodysplasia verruciformis (EV) can be defined as a genetic disorder that determines a lifelong infection of the skin by human Papillomaviruses (HPV). The benign lesions contain different HPVs; whereas in the tumors HPV types 5, 8, and, much less frequently, types 14, 17, 20 and 47 can be detected. Variants of HPV5 have been recognized on the basis of the genetic heterogeneity of the E6 open reading frame. We report a typical case of EV in which the presence and expression of the HPV type 5 were clearly detectable. Direct sequence analysis demonstrated a perfect homology with the sequence of the HPV5b variant. This variant was first isolated in a Japanese patient and thereafter in a Polish one. Its presence in the Italian patient indicates that the same variant can be detected in different geographic areas and therefore that some cellular genes may exert a selection pressure so strong as to induce the emergence of this stable HPV5b infectious variant.

Papuloverrucous colloid milium: an occupational variant.

We report a case of adult colloid milium in a 47-year-old mechanic with a long history of professional contact with lubricating oils and of sun exposure. In addition to the typical translucent papules seen on the forehead, there were warty papules on the backs of both hands with unusual histological and ultrastructural features: marked hyperplasia of the epidermis with orthokeratotic hyperkeratosis and papillary deposits of colloid material that were contiguous with the basal layer of the epidermis. The hand lesions caused by occupational exposure to mineral oils and solar radiation represent an occupational variant of adult colloid milium.

Primary cutaneous plasmacytoma: report of a case with review of the literature.

Primary cutaneous plasmacytoma (PCP) is a rare cutaneous B-cell lymphoma. We report a new case of PCP and review data published in the literature. A 55-year-old man presented with 2 erythematous plaques on the upper trunk, showing histologic and immunohistochemical features of PCP. Staging investigations excluded extracutaneous manifestations of the disease. The patient was treated with melphalan and prednisone associated with local radiotherapy. Twenty-four months after the first presentation he is alive and well. Only 29 cases of PCP have been reported in the last 50 years. The main prognostic factor seems to be the clinical presentation (solitary vs multiple lesions). Solitary lesions of PCP may be treated conservatively by surgical excision or local radiotherapy.

Epithelioid sarcoma.

Epithelioid sarcoma is a rare malignant tumor of the soft tissues with particular clinical and anatomicopathological characteristics. Histologically it is characterized by the presence of particular epithelioid cells. After a description of a recently observed case, the authors present a synthesis of the literature on the subject, paying particular attention to the clinical and histological aspects which facilitate an early and correct diagnosis.